Theory of mind in schizophrenia: meta-analysis

Br J Psychiatry. 2007 Jul;191:5-13. doi: 10.1192/bjp.bp.107.035899.


Background: Mentalising impairment (an impaired ability to think about people in terms of their mental states) has frequently been associated with schizophrenia.

Aims: To assess the magnitude of the deficit and analyse associated factors.

Method: Twenty-nine studies of mentalising in schizophrenia (combined n=1518), published between January 1993 and May 2006, were included to estimate overall effect size. Study descriptors predicted to influence effect size were analysed using weighted regression-analysis techniques. Separate analyses were performed for symptom subgroups and task types.

Results: The estimated overall effect size was large and statistically significant (d=-1.255, P<0.0001) and was not significantly affected by sample characteristics. All symptom subgroups showed significant mentalising impairment, but participants with symptoms of disorganisation were significantly more impaired than the other subgroups (P<0.01).

Conclusions: This meta-analysis showed significant and stable mentalising impairment in schizophrenia. The finding that patients in remission are also impaired favours the notion that mentalising impairment represents a possible trait marker of schizophrenia.

Publication types

  • Meta-Analysis
  • Research Support, Non-U.S. Gov't
  • Review

MeSH terms

  • Adult
  • Child
  • Child, Preschool
  • Cognition Disorders / epidemiology*
  • Cognition Disorders / psychology
  • Effect Modifier, Epidemiologic
  • Humans
  • Schizophrenia / classification
  • Schizophrenia / epidemiology*
  • Schizophrenic Psychology*
  • Severity of Illness Index
  • Social Perception*
  • Statistics as Topic